INCOME PROTECTION & LIFE INSURANCE

Transcription

1 INCOME PROTECTION & LIFE INSURANCE COMBINED PRODUCT DISCLOSURE STATEMENT & FINANCIAL SERVICES GUIDE

2 02 ABOUT THIS DOCUMENT This combined Product Disclosure Statement (PDS) and Financial Services Guide (FSG) is designed to help you decide whether to buy NRMA Life Insurance, NRMA Income Protection or both. The information contained in this PDS and FSG is general information only and does not take into account your individual objectives or financial situation. You should consider how appropriate these products are with regard to your objectives, financial situation and needs before making a decision whether to acquire one or both of these products. The PDS describes the main features and benefits of NRMA Life Insurance and NRMA Income Protection. The FSG contains important information about the services provided by the distributor and issuers of these products, the remuneration they receive, and external and internal dispute resolution services. ABOUT THE PROMOTER NRMA Life Insurance and NRMA Income Protection are promoted by IAL Life Pty Limited ABN Authorised Representative Number of 388 George Street, Sydney NSW 2000 (IAL Life). IAL Life is a subsidiary of Insurance Australia Limited ABN NRMA Insurance is a trading name of Insurance Australia Limited. IAL Life has been appointed as an Authorised Representative of TAL Direct Pty Limited ABN AFSL (TAL Direct). ABOUT THE DISTRIBUTOR TAL Direct deals in and provides general advice for these products and is the licensee responsible for the FSG and services provided. TAL Direct is related to TAL Life Limited ABN AFSL of 363 George Street, Sydney NSW 2000 (TAL Life) and is a subsidiary of TAL Dai-ichi Life Australia Pty Limited ABN ABOUT THE ISSUERS TAL Life is the issuer of the life insurance benefits outlined in this PDS. St Andrew s Insurance (Australia) Pty Ltd ABN AFSL of Level 6, 100 Skyring Terrace, Newstead Qld 4006, is the issuer of the involuntary unemployment benefit outlined in this PDS. TAL and St Andrew s are responsible for the entirety of the PDS and each is severally responsible for the claims assessment and payments, ongoing administration and operation of this product relevant to the respective cover they have issued. Neither IAL Life, Insurance Australia Limited (or its related bodies corporate) nor any of their employees, agents or other representatives, guarantee, accept liability or are otherwise responsible for these products.

3 03 CHANGES TO THE PDS AND FSG Information in this document that does not affect the cover terms and conditions may change from time to time. We may make such changes by amending the PDS or FSG and publishing an updated version on the website A printed copy of the information updated may also be obtained free of charge by contacting our Customer Service Centre on IMPORTANT INFORMATION The information in this PDS and FSG is current as at the date of issue. In this document, you and your refers to the policy owner or life insured as applicable. TAL, St Andrew s, we, us or our refers to TAL Life Limited, TAL Direct Pty Limited or St Andrew s Insurance (Australia) Pty Ltd as applicable. NRMA Insurance refers to Insurance Australia Limited.

4 04 CONTENTS WE RE PROTECTING YOUR MOST VALUABLE ASSET YOU. 05 PROTECTION FOR WHAT MATTERS MOST 05 PRODUCT DISCLOSURE STATEMENT PART ONE: NRMA LIFE INSURANCE 06 Why should you take out life insurance? 06 What are the benefits? 06 Creating your NRMA Life Insurance policy 07 Understanding your NRMA Life Insurance policy 09 Other things you need to know about your NRMA Life Insurance policy 12 PRODUCT DISCLOSURE STATEMENT PART TWO: NRMA INCOME PROTECTION 15 Why should you take out income protection? 15 What are the benefits? 15 Creating your NRMA Income Protection policy 16 Understanding your NRMA Income Protection policy 19 Involuntary Unemployment Cover 21 Optional Covers 24 What s not covered by my NRMA Income Protection policy? 26 Other things you need to know about your NRMA Income Protection policy 27 IMPORTANT INFORMATION 32 Privacy 32 How we manage complaints 33 Duty of Disclosure 34 Fraudulent claims 35 Opt-out 35 Paying by direct debit 36 Financial Claims Scheme 36 Risks 37 NRMA Income Protection and Life Insurance Definitions 38 FINANCIAL SERVICES GUIDE 43 About this guide 43 Who are our representatives? 43 Our services 44 What does general financial product advice mean? 44 Who we act for 44 How we are paid 45 Professional indemnity insurance 45 Dispute Resolution 46

5 05 WE RE PROTECTING YOUR MOST VALUABLE ASSET YOU. For over 85 years, NRMA Insurance has been insuring some of Australia s most valuable assets, including cars, home and contents, and businesses. We re proud to be working with one of Australia s major specialist life insurers, TAL Life, to bring you insurance to cover your most valuable assets you and your family. PROTECTION FOR WHAT MATTERS MOST We like to think we re in control of our future, but the truth is that life often throws unexpected challenges our way. And while we can t help you control the future, we can help make sure that you re prepared financially, whatever happens. That s why NRMA Insurance offers a range of insurance options, to help you safeguard your financial future and that of the people you care for most. Here s how our life insurance and income protection can help you and your family: What is it? Who is it for? Life Insurance Helps ensure the financial security of your loved ones with a lump-sum payment, so you can feel confident they ll be looked after, in the event of a tragedy. If you have debts, or people that rely on you to provide for them, then life insurance could be for you. Income Protection Income protection can help by providing monthly payments if you are unable to work due to Sickness, Injury or Involuntary Unemployment. If you can t imagine how you could afford to live if you were suddenly unable to work due to Sickness, Injury or Involuntary Unemployment, then income protection could be for you.

6 06 PRODUCT DISCLOSURE STATEMENT PART ONE: NRMA LIFE INSURANCE WHY SHOULD YOU TAKE OUT LIFE INSURANCE? Unfortunately, no one knows what lies ahead for our families. Nobody likes to consider it, but every day another Australian family experiences the unexpected stress of having a loved one pass away. What s more, many families are simply unprepared for the financial impact that can be added to the emotional one. Many people often mistakenly think they have adequate life insurance as a part of their superannuation. But this may not be enough to provide for your family s financial needs beyond the short-term. If you want to ensure your family will have the financial future you ve always envisioned, life insurance may be the answer. The flexibility of NRMA Life Insurance means that every Australian between the ages of 18 and 65 can take out a policy, and rest easy knowing their family can be financially protected from whatever the future holds. WHAT ARE THE BENEFITS? Here s a snapshot of the benefits offered by NRMA Life Insurance: Benefit A lump sum benefit for when your family needs it most Your choice of cover types Description Choose up to $1.5 million cover with guaranteed renewal until you turn 99, plus an advance payout of $10,000 to help your family when they need it most. Choose Fast Track Cover to apply with no health questions, or answer a few questions to access higher benefits and potentially lower premiums with our Comprehensive Cover option. See page 8 for details. NRMA Life Insurance

7 07 Benefit An insurer you know and trust Description Your NRMA Life Insurance policy is backed by the financial strength and security of TAL Australia s life insurance specialist. So you can feel secure that if you need to claim, you ll be in trusted hands. CREATING YOUR NRMA LIFE INSURANCE POLICY The best way for you to see how an NRMA Life Insurance policy can meet your needs and budget is to follow these simple steps. 1. CHOOSE HOW MUCH YOU D LIKE TO COVER YOUR FAMILY FOR Ultimately, the goal of your cover is to make sure your family has enough from your insurance benefit to continue living the lifestyle you helped to provide. Firstly, you will need to determine an ideal amount of cover by considering: Size of your family Size of your mortgage Number of children or dependents Cost of education and schooling Cost of living expenses Visit and click on the life insurance calculator to help determine the cover for you. Once your cover is in place, you can adjust the amount as your circumstances change, simply call us on CHOOSE BETWEEN COMPREHENSIVE COVER AND FAST TRACK COVER Now that you ve decided how much you would like to cover your family for, it s time to consider the best cover option for you. NRMA Life Insurance offers the flexibility of two kinds of cover one offering the most comprehensive cover, and one designed to save you time. NRMA Life Insurance

8 08 Here s a summary of our two cover types: About this cover Comprehensive Cover This policy requires you to answer some health and lifestyle questions, in return for more affordable premiums. Who can apply? Australian residents aged Maximum cover amount Discounts for existing NRMA Insurance policyholders Other Discounts Terminal illness payout Advance payout Cooling off period Exclusions Fast Track Cover This policy provides the convenience of fast and easy cover without the need to answer health questions. $1.5 million $750,000 Yes 5% discount for the life of your policy. Yes 30% off cover between $150,000 and $300,000, and 35% off cover above $300,000. Pay annually and receive one month s cover free. Yes we ll pay your benefit to you in full if you re diagnosed with a terminal illness with less than 12 months to live. Yes we ll give you a $10,000 advance payout to help towards legal or other expenses as soon as your claim has been approved. Yes you have 30 days after your insurance begins to cancel in writing or over the phone - if you cancel during this time we will give a complete refund of any premiums paid. Exclusions apply to both cover options. For this reason we strongly advise familiarising yourself with the list of what s not covered on page 10. Remember, if you re unsure of anything, you can always talk to one of our staff on NRMA Life Insurance

9 09 3. CHOOSE WHETHER TO ADD A SPOUSE OR PARTNER TO YOUR POLICY If you and your partner want to protect your family with life insurance, both of you can do so on one policy. You ll receive a discount of $3.30 per month for the second person. 4. CHOOSE WHO BENEFITS FROM YOUR POLICY You can nominate up to five people as beneficiaries, and decide how much of the benefit is given to each person. It s a safe way to make sure that your final wishes are respected. 5. CHOOSE WHEN YOU D LIKE TO PAY YOUR PREMIUMS We all get paid at different times of the month, so you can set up the payment of your premiums to coincide with your payday. You can pay by direct debit or credit card, and on any working day you choose. You can choose between: Fortnightly billing. Monthly billing. Quarterly billing. Annual billing. GET ONE MONTH FREE! If you choose to pay annually, you ll get one month free every year UNDERSTANDING YOUR NRMA LIFE INSURANCE POLICY It s important to us that every customer fully understands their policy. The following are answers to questions you might have and information you should know before taking out NRMA Life Insurance. If there is anything you re unsure of please call us on WHAT S NOT COVERED BY MY POLICY? Your NRMA Life Insurance covers you if you die, or are diagnosed by a registered medical practitioner with a terminal illness with less than 12 months to live. However, there are exclusions for both Comprehensive and Fast Track options. NRMA Life Insurance

10 10 What s not covered by my policy? Comprehensive Cover exclusions In the first 13 months of your policy*: No benefit is payable on the terminal illness or death of a Life Insured if either is the direct or indirect result of suicide or an intentional self-injury At any time if shown on your policy schedule: n Specific exclusions identified at the time we arrange your policy. For example, a regular skydiver may not be covered for skydiving incidents n Work-related exclusions may apply for specific occupations Fast Track Cover exclusions No benefit is payable on the Terminal Illness or death of the Life Insured which is the direct or indirect result of: n A Pre-Existing Medical Condition unless it can be proved to our satisfaction that the Life Insured has been Free of the Condition for the 5 years following the Cover Commencement Date, reinstatement or an increase in Cover you apply for; n Suicide or an intentional self-injury during the first 5 years following the Cover Commencement Date, reinstatement or any increase you apply for; n A Dangerous Occupation or Dangerous Pastime at any time following your Cover Commencement Date; n The Life Insured or Policy Owner s participation in any criminal activity at any time following your Cover Commencement Date; n A Known Genetic Condition at any time following your Cover Commencement Date. *From the date the policy started or was reinstated. If you have increased your cover amount, the same qualifying periods apply to the increased component of your benefit. NRMA Life Insurance

11 11 IF YOU HAVE FAST TRACK COVER AND A PRE-EXISTING MEDICAL CONDITION Pre-Existing Medical Conditions are not covered within the first 5 years of your Cover Commencement Date, reinstatement or any increase in Cover you apply for. After 5 years have passed, Pre-Existing Medical Conditions will be covered if you have been continuously Free of the Condition with no signs or symptoms and no recurrence, nor has any treatment been taken or required in the 5 years immediately following your Cover Commencement Date, reinstatement or any increase in Cover you apply for. For example: Cancer No Cover would be provided if, for example, you suffered from cancer in the 5 years prior to your Cover Commencement Date, and then passed away or became terminally ill as a result of this condition in the 5 years following your Cover Commencement Date. However, Cover would be provided if, for example, you were treated with cancer before taking out cover, were Free of the Condition for 5 years following the Cover Commencement Date, and were then diagnosed with terminal cancer more than 5 years after the Cover Commencement Date. For example: Heart Attack No Cover would be provided if you passed away from a heart attack within the first 5 years of your Cover Commencement Date, and in the first 5 years prior to your Cover Commencement Date you suffered from, for example, high cholesterol and/or hypertension. Likewise, no Cover would be provided if, for example, you passed away from a heart attack more than 5 years after your Cover Commencement Date, and you required treatment for pre-existing high cholesterol and/or hypertension at any time in the 5 years following your Cover Commencement Date. Although Fast Track Cover may not pay out for death due to Pre- Existing Medical Conditions, if we deny your claim because of a preexisting condition on Fast Track Cover, we will refund 50% of the premiums you have paid. NRMA Life Insurance

12 12 OTHER THINGS YOU NEED TO KNOW ABOUT YOUR NRMA LIFE INSURANCE POLICY WILL MY PREMIUMS INCREASE OVER TIME? It is important to help keep your family protected but as we all know, the cost of living keeps going up. You need to feel sure that the benefit your family would receive is enough to meet the financial demands of the future. That s why we increase your benefit amount each year until the policy anniversary before you turn 70, unless you ask us not to. Your benefit amount will rise in line with the change in the Consumer Price Index (CPI), or by 5%, whichever is higher, and your premiums will increase accordingly. In addition, premiums generally increase each year on your policy anniversary because you get older. You also have the option to freeze your life insurance premiums. In this instance we will not increase your premiums but instead we will reduce the amount you re insured for to match the premium you are paying. ARE MY PREMIUMS TAX DEDUCTIBLE? Generally, life insurance premiums are not tax deductible. We advise checking with an accountant to ensure that this applies to your individual tax situation. IS THE BENEFIT PAYMENT TAXED? Generally, any payout you receive as a result of a life insurance claim is tax-free. Again, please check with your accountant to ensure that this applies to your individual tax situation. NRMA Life Insurance

13 13 WHEN WILL MY POLICY BEGIN AND END? Your cover begins on the day we accept your application, being the Cover Commencement Date (the cover start date will appear on your policy schedule). Your cover ends on the earliest of the following: The date we pay your benefit in full; The expiry date shown on your policy schedule; The date your policy is cancelled (by us or you) or; The date your policy lapses due to non-payment of premiums. WHAT HAPPENS IF I STOP PAYING MY PREMIUMS? You must pay your premiums when due to keep your policy in force. Remember, this insurance is not an investment policy so if your policy is cancelled after the first 30 days, you won t receive any refund of the premiums you ve paid. We will always try to work out the best way for our customers to deal with any changing circumstances that may arise so please give us a call to discuss your options. WHY IS IT IMPORTANT I GIVE THE CORRECT INFORMATION? When you apply for NRMA Life Insurance, we will request information specific to your policy. You need to give us all the information requested, and answer all questions honestly and completely. This is your legal obligation called a duty of disclosure. If you don t, there s a chance that we may not be able to pay your claim. If you re unsure of anything, or feel uncomfortable about anything in the application process, please give us a call. If you re not comfortable sharing your health history with us, you can always consider taking out our Fast Track Cover option. With this option, if you re an Australian resident between 18 and 65, you can apply without the need for health questions or tests. NRMA Life Insurance

14 14 HOW DOES MY FAMILY MAKE A CLAIM IF THEY NEED TO? Firstly, make sure you ve given someone in your family, ideally your beneficiaries your policy details as this will make the process much quicker and simpler. Then, all they need to do is call us on to notify us of the claim. We will send claim forms, which includes a Medicare consent form, so we can obtain your complete medical records which we need to assess the claim. IN THE EVENT OF A CLAIM, WILL MY FAMILY BE TAKEN CARE OF? We understand that a life insurance claim is made during an incredibly emotional and difficult time. You ve trusted us to take care of your family during this time, and we can do just that. Your family will be assigned a Personal Claims Consultant to deal with the claim. They will also be offered free telephone bereavement counselling by a qualified grief counsellor. We will also pay an advance of $10,000 of the sum insured on acceptance of a death claim under the policy. This is to assist with the expenses involved in finalising the estate of the Life Insured. The balance of the sum insured will then be paid in accordance with the Grant of Probate or Letters of Administration. NRMA Life Insurance

15 15 PRODUCT DISCLOSURE STATEMENT PART TWO: NRMA INCOME PROTECTION WHY SHOULD YOU TAKE OUT INCOME PROTECTION? Sometimes a temporary setback can have a long-term effect on your lifestyle. If you were to get sick or injured and that meant you were unable to work, or if you became Involuntarily Unemployed how would you cope without a regular income? Income Protection Cover pays a regular monthly benefit if you are unable to work due to a Sickness or Injury. You could receive up to 85% of your pre-tax income, up to $10,000 per month, to help you cover your dayto-day costs. This means you can focus on recovery without worrying about your finances or how your family could afford to live. Optional Involuntary Unemployment Cover is also generally available, so you can protect yourself for up to 85% of your pre-tax income, up to $3,000 per month, for up to 3 months. And if you re already an NRMA Insurance policyholder, you ll enjoy a 5% discount on your premiums for the life of the policy. WHAT ARE THE BENEFITS? Here s a snapshot of the benefits offered by an NRMA Income Protection policy: Benefit Description A regular payment Up to 85% of your pre-tax income paid monthly if for when you re out you are off work due to Sickness or Injury, helping to of work cover your costs while you get better. Involuntary Unemployment Cover If you are self employed or a permanent employee working 30 hours or more per week, you may be eligible for Involuntary Unemployment Cover when you take out an NRMA Income Protection Policy. You could receive a regular payment for up to three months if you are made Involuntarily Redundant from your permanent role, or if you are selfemployed and your business becomes insolvent. You can choose to opt out of this cover to reduce the cost of your premiums. If you change your mind later, you can apply for or remove it at any time. See page 21 for details. NRMA Income Protection

16 16 Optional cover for extra protection for your family Benefit Essentials Cover Extend your cover for your family with Kids Injury Cover, Holiday Injury Cover or Permanent Disability Cover. See page 24 for details Description If you re not eligible for Income Protection Cover, because, for example you re not working, you may be eligible for Essentials Cover. Essentials Cover offers many of the same great benefits as Income Protection, and is available to eligible Australian residents aged You can apply for up to 85% of your income to $7,500 a month if you re in stable employment. If you re not working or working less than 20 hours per week, you can get cover up to $3,000 a month. CREATING YOUR NRMA INCOME PROTECTION POLICY NRMA Income Protection provides choices to suit your needs. 1. CHOOSE HOW MUCH YOU D LIKE TO COVER YOURSELF FOR When you re used to a certain level of income, it can be hard to get by without it. That s why NRMA Income Protection offers up to 85% of your pre-tax income, up to $10,000 per month, if you re unable to work due to Sickness or Injury. To work out how much cover you need, think about your family s monthly expenses, as well as any quarterly or annual expenses like school fees and rates. Even if you work less than 20 hours a week, you may still be eligible for up to $3,000 a month with our Essentials Cover. And don t worry if your circumstances change if you start earning more or less, you can apply to adjust your cover at any time. If you are working in permanent employment working 30 hours or more per week, you may be eligible for Involuntary Unemployment Cover, which covers up to 85% of your income up to $3,000 each month for up to 3 months when you take out an NRMA Income Protection policy. You can choose to opt out of this cover to reduce the cost of your premiums. If you change your mind later, you can apply for or remove it at any time. See page 21 for details. NRMA Income Protection

17 17 2. CHOOSE YOUR WAITING PERIOD Your Waiting Period is the time you need to be off work before you are able to claim. You won t receive any payments for this period. With Income Protection Cover you can choose a Waiting Period of 14, 28, 60 or 90 days for Sickness and Injury claims. The longer the Waiting Period you choose, the lower your premiums will be. Essentials Cover and Involuntary Unemployment Cover has a fixed Waiting Period of 28 days. 3. CHOOSE YOUR PAYOUT PERIOD The Payout Period is the amount of time we ll pay a benefit to you while you re Out of Action or Involuntarily Unemployed (see page 41 for more information). You can choose the Payout Period you would like for Sickness or Injury claims the shorter the Payout Period, the lower your premiums will be. Income Protection Cover has a choice of Payout Periods of 6, 12 or 24 months or five years. Essentials Cover has a choice of 6, 12 or 24 months. The maximum Payout Period for Involuntary Unemployment is 3 months. 4. CHOOSE YOUR OPTIONAL COVER You can choose to apply for these optional covers to help meet your family s needs: Holiday Injury Cover Kids Injury Cover Permanent Disability Cover Please see the section on Optional Cover on page 24 for more information. NRMA Income Protection

18 18 5. CHOOSE WHEN YOU D LIKE TO PAY YOUR PREMIUMS We all get paid at different times of the month, so you can set up your premium payments to coincide with your payday. If you are self-employed you can even set up your payments to match your quarterly business activity statements (BAS). You can pay by direct debit or credit card, and on any working day you choose. You can choose between paying: Fortnightly; Monthly; Quarterly; or Annually GET ONE MONTH FREE! If you choose to pay annually, you ll get one month free every year NRMA Income Protection

19 19 UNDERSTANDING YOUR NRMA INCOME PROTECTION POLICY It s important to us that you understand your policy that way you can be confident about when you re covered, and when you re not. This section includes important information about NRMA Income Protection. Please read it carefully to make sure that you re fully informed. ABOUT NRMA INCOME PROTECTION Here are some things you should know about our Income Protection policy: Who can apply? What s the maximum Payout Period? What are the Waiting Periods? What s the highest monthly payout you can receive? Is proof of income required at claim time? Are pre-existing conditions covered? At what age does the policy expire? Optional covers Income Protection Cover Australian residents aged 18-60, working more than 20 hours a week. For Involuntary Unemployment Cover, you must be a permanent employee and working 30 hours or more per week. Choose from 6, 12 or 24 months, or five years for Sickness and Injury. 3 months for Involuntary Unemployment claims. Choose from 14, 28, 60 or 90 days for Sickness and Injury claims. 28 days for Involuntary Unemployment claims. Up to 85% of your pre-tax monthly income, up to $10,000. The maximum for Involuntary Unemployment Cover is up to 85% of you income up to $3,000. Yes Yes - we ll ask you some questions to see if they can be. Exclusions apply. See page 26 to check what s not covered cover is limited to a maximum of $3000 a month from age 65. Involuntary Unemployment Cover will cease from age 65. Holiday Injury Cover Kids Injury Cover Permanent Disability Cover Involuntary Unemployment Cover NRMA Income Protection

20 20 Income Protection Cover Cooling off Period Discounts for existing NRMA Insurance policyholders? Other discounts Exclusions Yes - you have 30 days after your insurance begins to cancel in writing or over the phone - if you cancel during this time we will give a complete refund of any premiums paid. Yes - 5% discount for the life of your policy. Pay annually and receive one month s cover free. Exclusions apply. For this reason we strongly advise familiarising yourself with the list of exclusions on page 26. Remember, if you re unsure of anything, you can always give us a call on ABOUT ESSENTIALS COVER If you don t qualify for Income Protection Cover because of your health or lifestyle, cover may still be available for you. Essentials Cover provides financial protection against Sickness and Injury and is available for Australian residents between 18 and 60. It has many of the benefits of Income Protection Cover, however there are additional exclusions for Essentials Cover such as Pre-Existing Medical Conditions. See page 26 for details. Essentials Cover has a 28 day Waiting Period and a choice of 6, 12, or 24 months Payout Period. Essentials Cover also allows you to extend your family s protection by covering a non-working partner or spouse. ADD YOUR PARTNER AND SAVE! By adding cover for your spouse or partner to your NRMA Income Protection policy, you ll each receive a 5% discount on your premiums. NRMA Income Protection

21 21 INVOLUNTARY UNEMPLOYMENT COVER ABOUT INVOLUNTARY UNEMPLOYMENT COVER Involuntary Unemployment Cover helps you to manage your expenses if you re made Involuntarily Redundant from your permanent employment, or if you re self-employed and your business becomes insolvent. This optional benefit provides up to three months of payments while you look for work. HOW DOES IT WORK? You ll be covered for Involuntary Unemployment from six months after your Cover Commencement Date (unemployment arising before this time is excluded), and you can claim after you have been out of work for 28 days or more. You must have been in continuous permanent employment for the six months before the claim. Where your employer has given notice (including but not limited to mainstream media announcements), prior to the commencement of this benefit that the company may be offering or forcing redundancies, or that it may suspend or cease trade, any resulting unemployment will not be considered to be involuntary and no Involuntary Unemployment Benefit will be payable. Any insolvency in your own business, or bankruptcy must not have been apparent in the six months prior to, or following your Cover Commencement Date. To be eligible for Involuntary Unemployment Cover you need to be: Aged between 18 and 60. Self-employed or employed on a permanent basis and working for 30 or more hours a week. Once your cover is in place, it will continue until the anniversary following your 65th birthday, or until your policy is cancelled, whichever is the sooner. NRMA Income Protection

22 22 WHAT S NOT COVERED? If you take out optional Involuntary Unemployment Cover, please be aware that you are not covered for this benefit where you became aware of, or you were notified of redundancy within the 6 months immediately following commencement of the cover, or if your Involuntary Unemployment is a result of any of the following: Sickness or Injury; Voluntary redundancy or resignation, or abandonment of employment, or retirement; Unemployment arising as a consequence of circumstances known to you or where your employer has announced to the public or publicised in mainstream media, prior to the Cover Commencement Date, an intention to reduce staff numbers by way of redundancies; An employer terminating the Life Insured s employment during a probationary period; Being personally insolvent or under any form of personal insolvency administration, including bankruptcy, due to personal debts; Your business being unable to pay its debts, or you or your business being served with any document to commence proceedings or process for you or your business to be placed in any form of insolvency administration for business-related debts, at any time prior to or within the first six months from your Cover Commencement Date; The end of employment in a family business controlled by you or an immediate family member; Misconduct, dishonesty or engaging in criminal activities or illegal acts or drug and/or alcohol abuse or intoxication.; Poor performance in carrying out your occupation including dismissal following formal disciplinary procedures; Your refusal of any offer of reasonable alternative employment by your employer linked to your education, training and experience; Any strike or labour dispute or labour disturbance in which you and/or your employer is involved; NRMA Income Protection

23 23 The loss of, or not maintaining the currency of any licence, authorisation or permit required to operate the business, including the loss of a drivers licence, trade or professional certification; You cease work due to the seasonal, casual or temporary nature of employment, or a contract (including a fixed term contract), is terminated early or completed; Involuntary Unemployment occurring outside Australia; If you are in jail or otherwise lawfully detained. No Involuntary Unemployment Cover Benefit is payable if you were not employed on a permanent basis or were working for less than 30 hours a week immediately prior to claim, or you are not actively seeking work or are not registered with Centrelink or a recruitment agency approved by us to seek work while on claim. CAN I OPT OUT? Yes. This cover is generally offered if you re working 30 or more hours a week and are employed on a permanent basis when you take out an NRMA Income Protection policy. However, you can choose to opt out of this cover to reduce the cost of your premiums. If you change your mind later, you can apply for or remove it at any time. Claim requirements are set out in the policy document. NRMA Income Protection

24 24 OPTIONAL COVERS HOLIDAY INJURY COVER If you ve ever been injured while on holiday, you ll know the hassles it can cause. First, there are the visits to a new doctor or hospital. And depending on the injury, there may be a range of extra expenses, such as extended accommodation costs, or travel expenses to get you home earlier than planned. That s why we ve created our Holiday Injury Cover, which provides a one-off extra payment equal to your first month s benefit payment, up to $3,000, if you re injured during state school or public holidays, or you re more than 200km from home. For example, if you had $5,000 income protection plus Holiday Injury Cover, and were injured during the Christmas school holiday period, you would receive $8,000 (your standard cover amount plus your extra Holiday Injury Cover) for the first monthly payment for an approved claim. KIDS INJURY COVER There s nothing more stressful than seeing your children hurt. That s why it s important that you can look after them when they need it most. Kids Injury Cover pays you a cash benefit of up to $50,000 for a range of common childhood injuries, helping you cover expenses, such as those not covered by Medicare or health insurance, or to take time off to be there for your child. For example, Kids Injury Cover pays $1,000 for a broken arm or nose, and up to $50,000 for second degree burns or major head trauma. WHAT S NOT COVERED? Kids Injury Cover ends when your child turns 18 years of age or once a total of $50,000 has been paid. Kids Injury Cover does not cover claims directly or indirectly related to conditions that were present at birth (congenital disorders), or intentional acts. NRMA Income Protection

25 25 PERMANENT DISABILITY COVER If you suffer a permanent disability, it may take you and your family some time to adapt. Our Permanent Disability Cover gives you the choice of a lump sum benefit of between $50,000 and $500,000, to help take the financial pressure off while you adjust. You can use the payment any way you like, for example, to help pay for the cost of long term care. With Permanent Disability Cover, we ll pay a benefit if you are permanently unable to perform two or more of the following activities without assistance: Bathing - the ability to clean yourself in a shower or bath Dressing - the ability to put on and remove clothing Toileting - the ability to use a toilet, including getting on and off the toilet Mobility - the ability to get in and out of bed and/or a chair Feeding - the ability to move food from the plate into your mouth. If you are an Australian resident aged you can apply for this option. If your application is accepted, once cover is in place, it will continue until the anniversary following your 75th birthday. There is a waiting period of six months from the date of the disabling Sickness or Injury until we ll pay your benefit. WHAT S NOT COVERED? When added to Essentials Cover, you won t receive a benefit if the cause of your permanent disability is something you ve suffered from, known of, or should have been aware of in the five years before your cover started. Other exclusions apply, which are outlined on the next page. NRMA Income Protection

26 26 WHAT S NOT COVERED BY MY NRMA INCOME PROTECTION POLICY? Naturally, there are some things that aren t covered under your NRMA Income Protection policy. Here s a list of the exclusions that apply: What s not covered by my policy? General exclusions for both Income Protection Cover and Essentials Cover We won t pay a benefit if the claim is cause directly or indirectly by: n Any mental health disorder, including anxiety disorders, depression and stress, disorders related to fatigue, drug or alcohol abuse n Taking intoxicating liquor n Cancer, stroke or heart attack in the first six months after your cover starts n Normal and uncomplicated pregnancy n Terrorism, civil commotion or unrest in countries outside Australia, if the Australian government has advised against travel to that country n War or an act of war n An intentional self-inflicted act, including exposing yourself to risk of Sickness or Injury for any reason n Committing, or attempting to commit, a criminal offence We won t pay a benefit if you are in jail or lawfully detained. We may also apply other specific exclusions to your Income Protection Cover. These will be agreed with you when you take out your policy. Additional exclusions for Essentials Cover If you have Essentials Cover, we also won t pay a benefit for sickness or injuries caused by: n A Pre-Existing Medical Condition n A Dangerous Occupation or Pastime n Football related injuries that result in less than 90 days Out of Action. This means a 90 day Waiting Period applies from the date you are first Out of Action with this injury. n Back injuries that result in less than 90 days Out of Action. This means a 90 day Waiting Period applies from the date you are first Out of Action with this injury. If you were not able to, or only partially able to, perform your Regular Daily Activities before you started your policy, we may not pay a benefit. NRMA Income Protection

27 27 OTHER THINGS YOU NEED TO KNOW ABOUT YOUR NRMA INCOME PROTECTION POLICY THE PREMIUM YOU HAVE TO PAY IS SHOWN IN YOUR POLICY SCHEDULE. WILL MY PREMIUMS INCREASE OVER TIME? Premiums generally increase with age each year at the anniversary of your plan or if you increase your cover amount. Unless otherwise requested, your cover increases each year by 3% or the change in the consumer price index, whichever is higher, and your premiums will increase accordingly. This is to help ensure that your cover keeps up with rises in the cost of living. However, you should still check your policy regularly to ensure the amount you are covered for still meets your needs. We may put our premium rates up in the future, but any increases will apply to everyone on the same rates we ll never single you out for an increase. If we increase our premium rates, we ll give you 30 days notice. ARE MY PREMIUMS TAX DEDUCTIBLE? Income protection premiums are generally tax deductible, helping to make this valuable cover more affordable. However, if you make a claim, your benefits are generally taxed as part of your personal income. We advise checking with an accountant to ensure that this applies to your individual tax situation. WHEN WILL MY COVER BEGIN AND END? Your policy begins on the day we accept your application which will be shown in your policy documents. You must be under 60 years of age to apply, however, your cover can continue, as long as you pay your premiums, until the anniversary of your policy following your 75th birthday. After the anniversary of your policy following your 65th birthday, any Involuntary Unemployment Cover will end and Sickness and Injury Cover is NRMA Income Protection

28 28 limited to a maximum of $3,000 per month, for a maximum Payout Period of 24 months. If you stop paying your premiums, your policy will be cancelled. We will write to you before cancelling your policy. With respect to the Involuntary Unemployment Cover, this insurance may be renewed for further consecutive yearly periods upon payment of the Premium. Payment of your Premium is deemed to be acceptance of an offer of renewal for a further yearly period. If you continue to pay your Premium, then unless your Policy is cancelled or we advise you prior to the Policy Anniversary that we will not be renewing, a Policy on the same terms and conditions automatically comes in to existence for one year from the Policy Anniversary. WHAT HAPPENS IF I STOP PAYING MY PREMIUMS? You must pay your premiums when due to keep your policy in force. Remember, this insurance is not an investment policy so if your policy is cancelled after the first 30 days, you won t receive any refund of the premiums you ve paid. The premium is due on the date(s) and at the frequency shown in the Policy Schedule. You can change the frequency of premium payments at any time. If you are paying by direct debit, the premium will be deducted from the account that you have authorised us to debit, on the agreed date and frequency. If the agreed date falls on a weekend or public holiday, the deduction will be made on the next business day. We will always try to work out the best way for our customers to deal with any changing circumstances that may arise please give us a call to discuss your options. NRMA Income Protection

29 29 WHY IS IT IMPORTANT I GIVE THE CORRECT INFORMATION? When you apply for NRMA Income Protection, we will request information specific to your policy and situation. You need to give us all the information requested, and answer all questions honestly and completely. This is your legal obligation called a duty of disclosure. If you don t, there s a chance that we may not be able to pay your claim. If you re unsure of anything, or feel uncomfortable about anything in the process, please give us a call. If you re not comfortable sharing your health history with us, you can always consider applying for Essentials Cover. Australian residents aged between 18 and 60 can apply without the need for health related questions or tests. WHAT HAPPENS IF I M INJURED OR ILL MORE THAN ONCE? Unlike some other insurances, NRMA Income Protection has no limit to the number of times you can claim for separate Sickness or Injury. WHAT HAPPENS IF I RETURN TO WORK TOO SOON? Generally if you re Out of Action, you ll want to get back to your normal life as soon as possible. Unfortunately doing this can sometimes mean you return to work too soon, and your sickness or injury returns. Don t worry if this happens if you find you need more time to recover, you can request to continue your original claim without having to re-sit your chosen Waiting Period. You can restart your payments if: We agree that you re still unable to work You haven t gone over the Payout Period of your cover You restart your claim within 12 months of the date you returned to work. NRMA Income Protection

30 30 STATUTORY FUND The assets of TAL s Statutory Fund Number 1 will be liable for the payment of all benefits (except for Involuntary Unemployment Cover for which St Andrew s is liable). You have no rights to the assets of St Andrew s, TAL, or any TAL Statutory Fund. ALTERATIONS AND VARIATIONS This policy can only be changed by TAL and/or St Andrew s in writing. No other person or company including an agent of TAL has the right to change any part of this policy. HOW DO I MAKE A CLAIM IF I NEED TO? If you need to make an NRMA Income Protection claim, we ll make everything as easy as we can, with a Personal Claims Consultant to support you through the process, step by step. Simply call us on as soon as your doctor tells you you re unable to work for longer than your Waiting Period, or when you re made redundant and we ll send you a claim form so we can resolve your claim as quickly as possible. Once we have confirmation that you ve been Out of Action for the Waiting Period, your benefit will build up each day and we ll pay your first benefit at the end of the following month. See pages 40 and 41 for the definition of Out of Action. During the Waiting Period, and while you are receiving claims payments, we won t charge you any premiums. For sickness and injury claims, we ll calculate your income based on your average pre-tax personal income in the previous 12 months. If you are self-employed, pre-tax income does not include your business expenses. For Involuntary Unemployment Cover claims, supporting evidence of the involuntary nature of unemployment will be required: Evidence to our satisfaction that you are residing in Australia and actively looking for work on an ongoing basis whilst you are eligible for this benefit. A copy of your Centrelink, or Recruitment Agency form approved by us which confirms you have registered to find employment. Please note that you do not need to be receiving Centrelink Benefits to register to seek employment. NRMA Income Protection

31 31 For employees a Certified Copy of the Separation Certificate and written advice from the Life Insured s employer (on company letterhead and signed by the paymaster, company secretary, personnel manager, director or a person of similar senior standing in the firm) explaining the circumstances of the Life Insured s Involuntary Unemployment or the forced termination of his or her employment or contract. For the Self-Employed - a Certified Copy of a notice confirming the Life Insured s personal insolvency issued by the Australian Financial Security Authority (AFSA) or its successors or a Certified Copy of a Court Order or appointment of an insolvency administrator to the Life Insured s company. If you receive other income, such as workers compensation, unemployment benefits or social security while you re claiming, we may adjust your payment. However, we ll only do this if the combined amount of your NRMA Income Protection benefit and this other income is more than 85% of your usual monthly pre-tax income. If your claim is accepted, we ll start paying you monthly. Every month that you are unable to work you will need to complete and send us progress claim forms so that we can assess whether you are still entitled to a payout. Usually, you are responsible for any costs of providing the documents to support your claim. However, if your circumstance requires anything above our standard claims requirements, we ll pay for any costs incurred in meeting those requirements. NRMA Income Protection

32 32 IMPORTANT INFORMATION PRIVACY Personal and sensitive information is collected from you or about you to enable TAL, St Andrew s and NRMA Insurance to provide their products and / or related services to you. Further information may be requested from you at a later time, such as if you want to make alterations to your insurance policy or at claim time when financial and health information may need to be collected about you to process the claim. We rely on the accuracy of the information you provide. If you think that we hold information about you that is incorrect, please let us know using the communication methods above. The way in which we collect, use and disclose your personal information is set out in the respective privacy policies of the providers of this product and / or related services and is available on request or at: or call or call or call The privacy policies contain details about the following: the kinds of personal information that may be collected and held; how that personal information may be collected and held; the purposes for which that personal information may be collected, held and used; circumstances in which that personal information may be disclosed; how customers may access personal information about them and how they can correct that information; and how customers complaints will be dealt with that customers may have regarding privacy issues. If you do not supply the required information, we may not be able to provide our products and / or related services to you or pay your claim.

33 33 In processing and administering your insurance (including at the time of claim) your personal information may need to be disclosed to TAL, St Andrew s, NRMA Insurance and other entities including the following: your employer, general practitioners or health professionals (to verify any health information you may provide), your (or your employer s, if relevant) financial advisor, other related entities or partner organisations (including companies based overseas - further details of those countries are set out in the respective privacy policies of TAL, NRMA Insurance and St Andrew s), organisations to whom we outsource our mailing, administration and information technology, Government and regulatory agencies (if required or if authorised to do so), or any person acting on your behalf such as a lawyer or accountant. The website of the Office of the Australian Information Commissioner which is available at is a useful source of additional information about both the privacy rights of individuals and the privacy laws imposed on organisations such as ours. This website also contains sensible steps that individuals can take to protect their information when dealing with organisations and when using modern technology. We take no responsibility for the contents of this Government run website. HOW WE MANAGE COMPLAINTS If you have any questions regarding privacy related matters, about how we manage your information or a complaint relating to privacy or your policy more generally please contact us using the contact details below: In the event you have a complaint, please call us on and ask to talk to the complaints officer, or write to us as: Complaints Officer NRMA Life Insurance Reply Paid 72, Carlton South VIC 3053 We rely on the accuracy of the information you provide. If you think that we hold information about you that is incorrect, please let us know using the communication methods above.